Age-related macular degeneration (AMD) is a common eye condition that affects the macula, the part of the retina responsible for sharp, central vision. AMD is a leading cause of vision loss in the UK and typically occurs in people over the age of 50, causing a gradual loss of central vision, making it difficult to perform tasks like reading, driving, and recognising faces. Glasses can significantly improve the effects of AMD.
Types & Causes of Age-Related Macular Degeneration
The exact cause of AMD is unknown, but risk factors include ageing, genetics, smoking, cardiovascular disease and a poor diet. While there is no cure, treatments like anti-VEGF injections, laser therapy, and lifestyle changes can help slow progression, while glasses and other vision aids can help manage symptoms.
There are two types of AMD:
Dry AMD
In dry AMD, the macula gradually thins and deteriorates over time. This process can lead to the accumulation of drusen, small yellow deposits under the retina.
These deposits can disrupt the normal functioning of the retina and cause damage to the macula. As the macula weakens, it becomes harder to see fine details, and central vision may become blurry.
This gradual deterioration leads to slow and progressive vision loss, often starting with difficulty seeing in low light or reading small print, although AMD doesn’t cause complete blindness.
Wet AMD
Wet AMD is caused by the growth of abnormal blood vessels beneath the retina.
These vessels are fragile and can leak blood or fluid into the surrounding tissue, which distorts the macula and causes swelling. This sudden and rapid leakage can create a distorted or blurry central vision, and if untreated, it can lead to permanent scarring of the macula.
Wet macular degeneration typically causes more severe vision loss than dry AMD and can result in sudden vision changes, such as seeing straight lines as wavy or experiencing dark spots in the centre of your vision.
How to Lower Risks
While some risk factors like age and genetics cannot be changed, certain lifestyle changes may help reduce the risk of developing AMD:
- Quit Smoking: Stopping smoking can significantly lower risk.
- Maintain a Healthy Diet: A diet rich in leafy green vegetables, fish, and fruit provides essential nutrients supporting eye health.
- Regular Exercise: Staying active helps maintain overall health, including eye health.
- Losing Weight: Losing excess weight can reduce the risk of conditions like high blood pressure and diabetes, which are linked to an increased risk of AMD.
How Age-Related Macular Degeneration Causes Vision Loss
Both types of AMD primarily affect central vision because they impact the macula, while peripheral (side) vision usually remains intact. As the disease progresses:
- Central vision becomes increasingly blurry, making it difficult to read, drive, or recognise faces.
- In advanced cases, blind spots may develop in the central field of vision, which can make it hard to see objects directly in front of you.
Although AMD does not cause total blindness, it can significantly impact a person's ability to perform everyday tasks.
Early detection and treatment can help slow the progression of the disease and manage its effects on vision.
Symptoms of AMD
The symptoms of Age-Related Macular Degeneration (AMD) can vary depending on the type and stage of the condition. Early on, AMD may not present noticeable symptoms, but as it progresses, the following signs may appear:
- Blurry or Distorted Central Vision: Objects in the centre of the visual field may appear blurry or distorted, especially when trying to read or recognise faces.
- Difficulty Adapting to Low Light: People with AMD may struggle with vision in dimly lit environments, such as when entering a dark room or driving at night.
- Dark or Empty Spots in Vision: A blind spot or dark area may develop in the centre of your vision, making it hard to focus on objects directly ahead.
- Wavy or Distorted Lines: Straight lines, such as the edges of doors or windows, may appear wavy or distorted, which is known as metamorphosis.
- Colour Perception Changes: Colours may appear less vivid, or there may be a change in the way they are perceived.
- Difficulty Reading or Seeing Fine Detail: Fine details, like small print or facial features, become increasingly difficult to distinguish.
- Loss of Focus: A gradual loss of the ability to focus on detailed tasks, even in well-lit environments.
These symptoms can be subtle at first but tend to worsen, especially if AMD is left untreated, affecting one or both eyes.
Regular eye exams are important for detecting AMD early and managing its progression.
Living With Age-Related Macular Degeneration
Living with Age-Related Macular Degeneration (AMD) often requires adjustments to daily activities, and glasses can play a crucial role in managing vision loss.
Prescription glasses with magnifying lenses or high-contrast glasses, can help individuals with AMD see more clearly, especially for tasks like reading or using a computer. Reading can also be improved with the use of larger print or enlarged text, while anti-reflective coatings can reduce glare, making it more comfortable to see in bright conditions.
Those who suffer from AMD should wear glasses with an up-to-date prescription to ensure their glasses provide the right amount of vision correction.
When to See an Optometrist About AMD
If you notice any changes in your vision, it’s important to consult an eye doctor as soon as possible, especially if you experience symptoms such as blurred or distorted central vision, difficulty adjusting to low light, or dark spots in your field of view.
If straight lines appear wavy or your ability to see fine detail diminishes, these could be early signs of Age-Related Macular Degeneration (AMD).
If you have a family history of AMD or other risk factors like smoking or high blood pressure, it’s advisable to see an eye doctor regularly for monitoring, even if you don’t notice vision changes yet.
Early detection and treatment can help slow the progression of the condition and preserve vision.
Getting Diagnosed with AMD
Getting diagnosed with AMD requires regular eye exams for early detection.
During an exam, an optometrist or ophthalmologist may perform several tests, including a visual acuity test to measure clarity of vision, a dilated eye exam for a detailed view of the retina and macula, and an Amsler grid test to detect vision changes like wavy or missing lines.
Optical coherence tomography (OCT) also provides cross-sectional images of the retina to identify areas of thinning, thickening, or fluid accumulation.
Age-Related Macular Degeneration (AMD) FAQs
Can age-related macular degeneration be treated?
While there is no cure for Age-Related Macular Degeneration (AMD), treatments can help slow its progression and manage symptoms.
For wet AMD, anti-VEGF injections are often used to reduce fluid leakage and prevent further damage. There is also photodynamic therapy, which combines a light-activated drug with a laser to destroy these vessels. Laser surgery can also be used to seal leaking blood vessels.
Dry AMD currently has no specific medical treatment, but lifestyle changes such as diet adjustments, supplements, and the use of low-vision aids, like prescription glasses, can help manage the condition and preserve vision.
Can dry macular degeneration stop progressing?
Dry macular degeneration typically progresses slowly, and while it can’t be completely stopped, treatments can slow its advancement. People with macular degeneration should get regular eye exams and use supplements containing lutein and zeaxanthin which has been shown to potentially help slow the deterioration of the macula.
Wearing glasses with UV protection and anti-glare coatings can also assist in managing daily activities and reducing strain on the eyes.
What is the main cause of macular degeneration?
The exact cause of macular degeneration is not fully understood, but the condition is primarily associated with ageing.
Other contributing factors include genetics, smoking, high blood pressure, and a poor diet. People with a family history of AMD are at a higher risk, so regular eye exams are essential to monitor early signs of the disease and assess the need for corrective eyewear.
How quickly do you lose your sight with macular degeneration?
The rate at which vision is lost varies from person to person. In the case of dry macular degeneration, it tends to cause a slow loss of vision that occurs over time, sometimes spanning several years. However, wet AMD can lead to more rapid vision loss due to the growth of abnormal blood vessels under the retina.
Both types cause the sufferer to lose central vision.
Can you stop the progression of dry macular degeneration?
While dry macular degeneration cannot be entirely stopped, its progression can be slowed. The use of specific vitamins and minerals can help preserve vision. Lifestyle modifications including the use of UV-blocking glasses and maintaining a healthy diet, are important steps in slowing its progression.
Does dry macular degeneration always get worse?
Dry macular degeneration typically worsens over time, though the rate of progression can vary. It is also classed as an age-related eye disease meaning vision may get worse with age.
Some individuals experience slow changes in vision, while others may have a more rapid decline. While there is no cure, interventions like corrective eyewear and nutritional supplements can help maintain vision for as long as possible and improve quality of life.
What is an early symptom of macular degeneration?
An early symptom of macular degeneration is blurred or distorted central vision. You may notice that straight lines, such as door frames or lines on a page, appear wavy.
Difficulty reading small print or seeing faces clearly can also be early warning signs. If you experience these symptoms, it’s important to see an eye doctor promptly for a full eye exam.
What is the best way to treat macular degeneration?
The best treatment options for macular degeneration depend on the type and severity of the condition. For wet macular degeneration, anti-VEGF injections can help manage fluid buildup and prevent further damage. For dry AMD, there’s no specific treatment, but lifestyle changes, nutritional supplements, and vision aids can improve vision quality.
Can macular degeneration cause sudden vision loss?
While dry macular degeneration typically leads to gradual vision loss, wet AMD can cause sudden vision loss due to abnormal blood vessel growth beneath the retina. This type of vision loss can occur quickly, and immediate treatment is crucial to prevent further damage. Early intervention and consistent monitoring through eye exams are essential to managing the condition.
